Provider Demographics
NPI:1023316353
Name:PAULETTE, ROLAND JAMES
Entity type:Individual
Prefix:
First Name:ROLAND
Middle Name:JAMES
Last Name:PAULETTE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 HILLSIDE DR
Mailing Address - Street 2:
Mailing Address - City:ORRINGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04474-3809
Mailing Address - Country:US
Mailing Address - Phone:207-949-7663
Mailing Address - Fax:
Practice Address - Street 1:37 HILLSIDE DR
Practice Address - Street 2:
Practice Address - City:ORRINGTON
Practice Address - State:ME
Practice Address - Zip Code:04474-3809
Practice Address - Country:US
Practice Address - Phone:207-949-7663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-10
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME3747P1801X
3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty